Corticosteroids and human recombinant activated protein C for septic shock.
This article summarizes the current knowledge on the benefit/risk profile from the use of low-dose corticosteroids and activated protein C in treating septic shock. Physicians should consider using low-dose corticosteroids and drotrecogin alpha activated in the treatment of patients who have vasopressor-dependent septic shock with persistent signs of hypoperfusion, organ dysfunction, or hypotension. The optimal timing for initiating these treatments is from 6 to 24 hours from onset of shock. When patients are receiving these drugs, physicians should systematically screen for superinfection and serious bleeding events.
Colin
Gwenhaël
G
Assistance Publique Hôpitaux de Paris, General Intensive Care Unit, Hôpital Raymond Poincaré (AP-HP), Université de Versailles SQY (UniverSud Paris), 104 Boulevard Raymond Poincaré, 92380 Garches, France. djillali.annane@rpc.aphp.fr
Annane
Djillali
D
D018806:APACHE; D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D015337:Multicenter Studies as Topic; D009102:Multiple Organ Failure / Q000188:drug therapy / Q000401:mortality; D011486:Protein C / Q000009:adverse effects / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D012772:Shock, Septic / Q000188:drug therapy* / Q000401:mortality; D015996:Survival Rate
D000305:Adrenal Cortex Hormones; D005343:Fibrinolytic Agents; D011486:Protein C; D011994:Recombinant Proteins; C421124:drotrecogin alfa activated